便携腹部战创伤微创诊疗装备研发与评价研究  

Development and application of portably minimally invasive diagnostic and therapeutic device forabdominally warfare trauma

作　　者：王泽 崔昊 陈润开 袁震 卫勃[1,2] 崔建新 Wang Ze;Cui Hao;Chen Runkai;Yuan Zhen;Wei Bo;Cui Jianxin(Department of General Surgery,The First Medical Center of Chinese PLA General Hospital,Beijing 100853,China;School of Medicine,Nankai University,Tianjin 300071,China)

机构地区：[1]解放军总医院第一医学中心普通外科医学部,北京100853 [2]南开大学医学院,天津300071

出　　处：《中国医学装备》2024年第10期29-35,共7页China Medical Equipment

基　　金：国家自然科学基金(82073192,62133010);北京市科技计划(Z221100007422125);中国人民解放军总医院医学工程实验室项目(2022SYSZZKY16);中国人民解放军总医院青年自主创新科学基金(22QNFC001)。

摘　　要：目的:设计研发针对一线救治环境现场的便携腹部战创伤微创诊疗装备,通过动物实验初步评价其应用可行性。方法:基于一线救治环境的现实需求,研发并组装一套便携腹部战创伤微创诊疗装备(简称微创诊疗装备),其中包括便携化集成主机、一次性可弯曲腔镜镜头、一次性微创手术器械、免气腹可撑开通道器等。选用1只雄性小型巴马猪,将其全麻后进行便携微创诊疗装备与传统腹腔镜的外科手术,对比两种装备术中实质脏器的止血、胃肠穿孔封堵修补及腹腔盆腔置管引流等损伤控制,比较与传统腹腔镜机动性能差异;开展损伤控制外科微创手术操作,评价其临床转化潜能。结果:微创诊疗装备相比传统腹腔镜具有良好的机动性能,微创诊疗装备在救治现场的转运时间为(3.3±1.0)min,显著短于传统腹腔镜的(14.5±3.2)min,其差异有统计学意义(t=-5.786,P<0.05)。微创诊疗装备可顺利实现气腹或免气腹条件下腹腔探查、冲洗、吸引、止血、修补、引流等损伤控制外科手术,操作安全可行。结论:研制的便携腹部战创伤微创诊疗装备在现有腹腔镜平台基础上集成优化,机动便携,可顺利实现损伤控制外科手术操作,具有良好的应用前景与临床转化能力。Objective:To design and develop a portably minimally invasive diagnostic and therapeutic device for abdominally warfare trauma,which aimed at a scene of rescue environment at frontline,and its feasibility was evaluated preliminarily through animal experiment.Methods:Based on the actual demands of the rescue environment at frontline,a set of portably minimally invasive diagnostic and therapeutic device for abdominally warfare trauma(abbreviation:minimally invasive diagnostic and therapeutic device)was researched,developed and assembled,which included portably integrated host,disposable flexible lens of endoscope,disposable apparatus of minimally invasive surgery,extendable channel device of avoiding pneumoperitoneum and so on.A male Bama miniature pig was selected,and it received two different surgeries included portably minimally invasive diagnostic and therapeutic device,and conventionally laparoscopic surgery after it received general anesthesia.The damage controls included hemostasis of intraoperative parenchyma organ,sealing and repairing of gastrointestinal perforation and drainage of indwelling catheter in abdominal and pelvic cavity between two groups were compared,and the difference of the mobility performance between them also was compared.The operational evaluation of minimally invasive surgery of damage control surgery and the potential of its clinical conversion were conducted.Results:Compared to conventional laparoscopy,this minimally invasive diagnostic and therapeutic device had better mobility,and the transfer time of this device was(3.3±1.0)min,which was significantly shorter than(14.5±3.2)min of conventional laparoscopy,and the difference of that between two device was significant(t=-5.786,P<0.05).The minimally invasive diagnostic and therapeutic device could successfully realize a series of operation of damage control surgery included exploration,flushing,suction,hemostasis,repair and drainage under the pneumoperitoneum or without pneumoperitoneum,which operation was safety and feasibility.Co

关 键 词：腹部战创伤 微创 便携 损伤控制手术 一次性可控柔性腹腔电子内窥镜 

分 类 号：R318.6[医药卫生—生物医学工程]